Withdrawal of phenobarb

RE: Withdrawal of phenobarb

Anthony Todd — Mon, 15 Jul 2019 12:46:00 GMT

[quote user="robloxley"]I think your criteria for starting phenobarb will also affect how many[/quote]

True, so do many start barbs after just one fit, I don't think I did??

Do many animals have just one?

I just got the owner to observe closely and check circumstances etc. if it had another.

RE: Withdrawal of phenobarb

Rob Loxley — Sun, 14 Jul 2019 21:06:49 GMT

[quote user="Anthony Todd"]

Anyone got any ball-park experience of animals not having permanently repeated seizures? ie how many do come off barbs permanently??

I could only say "some"

[/quote]

I think your criteria for starting phenobarb will also affect how many

RE: Withdrawal of phenobarb

Anthony Dennison — Fri, 12 Jul 2019 15:29:50 GMT

[quote user="Anthony Todd"]

Anyone got any ball-park experience of animals not having permanently repeated seizures? ie how many do come of barbs permanently??

I could only say "some".

[/quote]

I've been qualified 7 years and I can think of 5 cases. 2 are collies from the same family.

RE: Withdrawal of phenobarb

Anthony Todd — Fri, 12 Jul 2019 13:08:21 GMT

Anyone got any ball-park experience of animals not having permanently repeated seizures? ie how many do come off barbs permanently??

I could only say "some".

RE: Withdrawal of phenobarb

David Mills — Fri, 12 Jul 2019 01:08:32 GMT

In the human field, apparently upto a third of people on anti-seizure medication actually are suffering from an intermittent arrhythmia causing syncopal episodes.

RE: Withdrawal of phenobarb

Stephen Courtney — Thu, 11 Jul 2019 15:38:08 GMT

I reduce by about 25% per month, so take 3-4 months to withdraw altogether.

I also have a client who took his dog off epiphen abruptly - stopped asking for repeats and i didn’t realise till he was in for a vaccination. No problem whatsoever. Go figure.

RE: Withdrawal of phenobarb

Joyce Whitehead — Tue, 09 Jul 2019 20:17:06 GMT

We had a young dog that presented at about age 2 I think, in status. Really hard to stabilise, had to have her anaesthetised for ages, then very altered on recovery. Went for mri as well insured, and found brain swelling but no real apparent cause. Suspected toxicity as started immediately after a walk. We kept her on the drugs for a year then reduced them over a very long period. We dropped dose every 3 months till she was off them. She has never fitted again. We took her spleen out last week as she had a splenic mass in fact (not ruptured, she presented acutely vomiting due to the spleen rotating the intestines and causing a partial obstruction).

RE: Withdrawal of phenobarb

Thomas Johnson — Tue, 09 Jul 2019 19:02:09 GMT

[quote user="Beats"]Call me a wimp, Karen, but I wouldn't stop. Cluster seizures can be bad. I get that you don't know and it could have been an intoxication or something, but you might get them again on weaning/ceasing phenobarb should it have been epilepsy.[/quote]

My reason for considering withdrawal would be that in an animal that presented with seizures at a young age, and has now had a long period seizure free, it could have had epilepsy, but it has resolved.

RE: Withdrawal of phenobarb

George Cooper — Tue, 09 Jul 2019 17:02:18 GMT

personally I treat cases that are presented on my table, and not blood results!!

RE: Withdrawal of phenobarb

Anthony Todd — Tue, 09 Jul 2019 10:30:04 GMT

[quote user="Beats"]blood levels of phenobarb have turned out to have been perfectly therapeutic in my experience [/quote]

Yes, the dose rates of phenobarb are solely based on the concensus of observed therapeutic response [ie our discredited friend the "anecdote" and not on anything "scientific".

Rather like the "drunk" because he/she can't walk in a straight line as opposed to the "drunk" who just has a certain blood level.

PS Can you hit the answer button yourself?

RE: Withdrawal of phenobarb

Beats — Mon, 08 Jul 2019 23:18:39 GMT

Call me a wimp, Karen, but I wouldn't stop. Cluster seizures can be bad. I get that you don't know and it could have been an intoxication or something, but you might get them again on weaning/ceasing phenobarb should it have been epilepsy.

Unless significant side effects, I'd probably continue as is.

"sub-therapeutic" blood levels of phenobarb have turned out to have been perfectly therapeutic in my experience in the past (i.e. on weaning phenobarb: relapses and end up on much higher doses to get back under control again...)

I'd probably continue same dose and let it continue to slowly "self-wean" and hope for the best.

RE: Withdrawal of phenobarb

Thomas Johnson — Wed, 03 Jul 2019 11:09:13 GMT

[quote user="Clive Ansell"]

Don't know where it comes from, but I do it over 6 weeks, and dose 3/4 for 2 weeks, 1/2 next 2 weeks, then 1/4 dose last 2 weeks, then stop. Not had any major problems, although in some dogs seizures have returned.

[/quote]

I've done similar, though I've waited 3-4 weeks between each dose change as I understand that phenobarb takes 2-3 weeks to reach steady state after any dose change.

RE: Withdrawal of phenobarb

Clive Ansell — Wed, 03 Jul 2019 10:55:11 GMT